In the past years

endoscopic therapy for early esophageal cancer has been gained gradual acceptance worldwide. Endoscopic therapy can improve longterm outcomes of patients with superficial esophageal cancer

and produce fewer complications than esophagectomy. However

it should be kept in mind that the widespread endoscopic mucosal resection can cause strictures

especially when more than two thirds of the circumference is removed. It should ideally be restricted to less than two thirds of the esophageal circumference in order to reduce the risk of strictures

but all visible lesions should be resected. Strictures resulting from mucosal resection respond well to dilation. In addition

the most significant drawbacks of using endoscopic mucosal resection as a curative treatment is the reliability of pre-procedure assessment of the depth of invasion of the neoplasia

as well as the recognition of the lymph node involvement. The improvement of diagnostic methods

especially endoscopic ultrasonography (EUS)

will allow careful selection of patients

and minimize the risk of undertreatment. Technical improvement of the devices and the possibility of avoiding significant strictures after mucosal resection will increase its use. Endoscopic treatment should be preferred over surgical treatment for management of most patients with highgrade dysplasia or mucosal cancer in the esophagus. The purpose of this article is to review the application of endoscopic techniques in the diagnosis and treatment of early esophageal cancer and bring forward some points worth noting in the process.